Open Letter to the Department of Health N.I. re Perinatal Mental Health

Let’s talk Mental Health! For the past four months I have been blogging about my struggle with, and recovery from, Postnatal Depression. Statistics suggest that as many as 10-15% mums also battle with it. That equates to thousands of women, in Northern Ireland, who struggle every year.

On this journey I have met many people from all walks of life. Some who are currently struggling; some who are in recovery; some who have scars from past treatments; and others who are actively working and campaigning to help those in need. My blog has been inundated with women contacting me to share their story. While we don’t all have the same experiences – the overriding message I have heard is – more needs to be done. More needs to be done to educate our society about Perinatal Mental Health (PMH); more needs to be done to educate those who are in a position to help; and more needs to be done to support mums, dads and families who are struggling.

To put it succinctly, we need to increase awareness and understanding of Perinatal Mental Health in Northern Ireland whilst also improving the support available.

I thought it might be helpful for you to hear what I am hearing, from lots of different mums, on the topic. From listening to numerous experiences, let me share the common issues and problems women have faced. Addressing these would allow us to move towards increasing awareness and understanding and improving support.

Many women have noted the need to be educated themselves about Perinatal Mental Health. I, like many other women who have got in touch, heard nothing before giving birth about how the experience could affect my emotional and mental health. I believe discussing this openly, and in appropriate detail, would be beneficial in Antenatal Classes. If this were to be the case, mums themselves could be prepared to deal with difficulties much quicker and partners/family members/birth partners could also look-out for certain tell-tale signs.

It has also been suggested, when Health Professionals are visiting the home after the birth, enough time is not always given to discussing a mother’s mental and emotional state, never mind actively looking for the signs. Many mothers have reported they were only asked these questions as, what they have termed, an “add-on”; they were rushed in giving answers and their concerns were not followed up. Some felt “no time” at all was given to this issue. I have also heard from a selection of mums who felt the support was so lacking that it was further damaging to the their state of well-being.

Many women have complained that when they approached a Health Professional for help, with how they were feeling, they got nowhere. On too many occasions, mums are dismissed as simply having the “baby blues”, when in fact it is something much deeper. This means there is a time lag in receiving appropriate treatment, which is not acceptable. Perhaps the question to be asked is – do we need re-education about PMH and how problems present themselves?

Concern has also been noted, by mums experiencing problems, that the next step is not always known, when a diagnosis is finally given. Many mums have been left for months, on waiting lists, for a service that was never going to meet their needs. Many have had to take to finding support and services for themselves, which is far from ideal. There are of course others, who, in not knowing where to turn, are left in misery, hoping that someone will hear them and help them. This is not good enough – we need a clearer pathway, known by all, towards help, support and resources.

A number of mums have noted that medication alone is not the answer and yet felt that was all they were offered. These mums have suggested they would have also benefited from counselling, CBT and peer support groups. But again, on many occasions, had to seek this out for themselves. Unfortunately, it can be location which determines how much support there is available. Some mums live in areas where there are accessible resources, others feel very isolated and alone as there are limited support outlets.

There is no one ‘go to’ place where you can find information on the help and support for PMH. For example, a website that provided details of all types of organisations that offered support and resources by area, would be very welcomed by mums. Having centralised information would mean that everyone could have access to the same details and could be informed of all the options.

Returning to work has also been a big issue for mums, who have recovered or are recovering from PMH issues. Many felt that employers had no concept of the issues they were facing and made no attempt to accommodate or make their return simpler. It seems there could be more support available when struggling mums are returning to employment. From listening to stories, I would go as far as to suggest that many mums end up not working, as their return has been so difficult. Surely this is not what we want and is not in the best interest of anyone in our society? A campaign, to raise awareness of PMH in general, would go a long way to help with this.

Finally, as has been highlighted already in the media recently, mums have drawn my attention to the fact that we do not have a Mother and Baby Unit in Northern Ireland. Without this resource, treatment and recovery remains very difficult for some mums; so there are many calls for this to be addressed.

Since beginning my blog, I have also had contact with a number of charities and organisations in Northern Ireland, sharing with me what they are doing within the area of PMH. I want to go on record to say there is great work ongoing and much to be praised – a lot of it we just don’t know enough about. I have discovered that mums are very resilient, despite suffering the horror and heartache of PMH issues; many have taken to organising peer support themselves; this is to be applauded. More needs to be done to encourage them in this role and to provide resources for any who might be interested in developing something in the future.

The purpose of this letter is not to attribute blame, or complain about our Health Professionals – I fully recognise there is much great work and support given by many. My purpose, and hope, is to highlight the area of PMH and the need for Northern Ireland to do more on this issue. So, to any who are reading, I ask this simple question – Will you join me, and the vast number of others who are concerned about the levels of awareness and support for PMH in Northern Ireland, in promising to play your part to increasing awareness; understanding of the issue; and to improve the resources available for this immensely important area of Mental Health?

I would be very happy to discuss this issue with any of you further, should you wish – in fact, I would welcome the opportunity.

Yours sincerely,

Lindsay Robinson

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Edit – This letter was sent first to the then Health Minister, Simon Hamilton, and subsequently, to the next Michelle O’Neill. Both replied. You can read their replies here: